卵母细胞单精子显微注射后卵母细胞退化:多因素分析评估其作为实验室或临床标记的重要性

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Objective:Oocyte degeneration has historically been associated with the intracytoplasmic sperm injection(ICSI) technique. We sought to determine whether oocyte degeneration rates were associated with the technician performing the procedure,the baseline characteristics of the patient,and/or ovarian stimulation variables. We also evaluated whether the degeneration rate could serve as a surrogate marker for implantation potential. Design:Cohort study. Setting:Academic medical center. Patient(s):Couples undergoing ICSI. Intervention(s):Six thousand six hundred fifty-three injected oocytes were analyzed to determine whether the degeneration rate was technician dependent. Two hundred thirty first-entry down-regulated cycles were examined to identify predictors associated with oocyte degeneration. Multivariate analyses were performed using generalized linear model routines. Main Outcome Measure(s):Oocyte degeneration rates and implantation rates. Result(s):Neither the ICSI technician nor the stripping technician was associated with the oocyte degeneration rate. However,the day 3 FSH,number of mature oocytes retrieved,and E2 levels on the day of hCG were significant independent predictors of degeneration rate. Physician-adjustable ovarian stimulation variables were not associated with the degeneration rate. The degeneration rate did not appear to be associated with the implantation rate. Conclusion(s):These data suggest that oocyte degeneration is not technician or physician dependent. Degeneration is likely a function of the inherent oocyte quality in women who underwent ovarian stimulation. However,the remaining cohort of retrieved oocytes appears to be unaffected by virtue of an uncompromised implantation rate. Objective: Oocyte degeneration has historically been associated with the intracytoplasmic sperm injection (ICSI) technique. We sought to determine whether the technician performs the procedure, the baseline characteristics of the patient, and / or ovarian stimulation variables. We Design: Cohort study. Setting: Academic medical center. Patient (s): Couples undergoing ICSI. Intervention (s): Six thousand six hundred fifty-three injected oocytes Two hundred thirty first-entry down-regulated cycles were examined to identify predictors associated with oocyte degeneration. Multivariate analyzes were performed using generalized linear model routines. Main Outcome Measure (s): Oocyte degeneration rates and implantation rates. Result (s): Neither the ICSI technician nor the However, the day 3 FSH, number of mature oocytes retrieved, and E2 levels on the day of hCG were significantly independent predictors of degeneration rate. Physician-adjustable ovarian stimulation variables were not associated with the The degeneration rate did not appear to be associated with the implantation rate. Conclusion (s): These data suggest that oocyte degeneration is not technician or physician dependent. Degeneration is likely a function of the inherent oocyte quality in women who underwent ovarian stimulation. However, the remaining cohort of retrieved oocytes appears to be unaffected by virtue of an uncompromised implantation rate.
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期刊
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